A clinical study of non-tuberculous pulmonary mycobacteriosis

Abstract

We studied the clinical features of sixty-one patients with non-tuberculous pulmonary mycobacteriosis (NTM), who were newly diagnosed at five national hospitals in Kinki area during 1993. The study subjects were composed of 31 patients with M. avium complex (MAC) disease (20 males and 15 females), 21 with M. kansasii (MK) disease (19 males and 3 females), 2 males with M. szulgai (MS) disease and 2 females with M. chelonae (MC) disease. The rate of NTM to all culture proven mycobacteriosis was 20.2% and the rate of NTM to all culture proven, newly discovered mycobacteriosis was 18.2% and the rates were higher than Sakatani's report in 1994 (14% in 1991). The ratio of MK to MAC was 22:35, and the ratio of MK was higher than the report of Sakatani. The mean age of patients with MK was 57.9 in male and 76.7 in female, that with MAC was 71.0 in male and 70.1 in female, that with MS was 57.0 in male and that 72.5 with MC in female. The proportion of elderly patients was higher than the former reports in Japan, especially in female with MK. The main lesions on chest X-ray was found in bilateral S1, 2(S1+2), particularly in the cases with cavitary lesions, but right middle lobe and left lingular lobe were mainly affected in some patients with MAC and S6 was often affected in elderly patients with MK. The chemotherapy with isoniazid, rifampicin, ethambutol and/or streptomycin (or kanamycin) w as highly effective in case with MK and MS disease, the efficacy was similar to pulmonary tuberculosis. Some patients with MAC were treated with combination of anti-tuberculosis drugs and new quinolons and/or clarythromycin, but the efficacy was not yet revealed.